Neutropenia rate of docetaxel/ cyclophoshamide regimen – pro

The issue in is whether the docetaxel/ cyclophashamide regimen has a febrile neutropenia rate of 20% or more when used in the usual manner in adjuvant treatmetn of breast cancer. The issue is solely whether the docetaxel/ cyclophashamide regimen has a febrile neutrropenai rate of 20% or more when used in the usual manner in adjuvant treatment of breast cancer. The original Journal of Clinical Onology paper(Dec 1 206)reported a febrile nutropenia rate of 5%, whereas there is also a figure of 41% drawn from a paper reporting solid tumors in a phase I setting.

However, a more recent reviews have put the risk of febrile neutropenia with this regimen as high a 33%. This accords with actual clinical experience of practicing oncologists. The disrepancy seems to be explainable by the setting. In the university setting, for unclear reasons, there is less febrile nutropenia with this regimen than in the community. I therefore think that G-CSF prophyalxis is appropriate according to the NCCN and ASCO guidelines. These set G-CSF use as appropriate for febrile neutropenia risk of 20% or more.

T. Vandenberg, BA MD, J. Younus, MD, and S. Al-Khayyat, MD Febrile neutropenia rates with adjuvant docetaxel and cyclophosphamide chemotherapy in early breast cancer: discrepancy between published reports and community practice—a retrospective analysis Curr Oncol. 2010 April; 17(2): 2–3.
However, more recent reviews have put the risk of febrile neutropenia with this regimen as high a 33%. This accords with actual clinical experience of practicing oncologists. The disrepancy seems to be explainable by the setting. In the university setting, for unclear reasons, there is less febrile nutropenia with this regimen than in the community. I therefore agree with the client’s methodological point but remain of the opinion that G-CSF prophyalxis is appropraite according to the NCCN and ASCO guidelines.
T. Vandenberg, BA MD, J. Younus, MD, and S. Al-Khayyat, MD Febrile neutropenia rates with adjuvant docetaxel and cyclophosphamide chemotherapy in early breast cancer: discrepancy between published reports and community practice—a retrospective analysis Curr Oncol. 2010 April; 17(2): 2–3.

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